- Discussion:
- insufficiency frxs of sacrum and pelvis may be confused w/ metastatic lesions, especially if bony resorption occurs at frx ends;
- these injuries may also occur in patients with known malignant disease who have a sudden onset of pain in the lower back, hip, or groin;
- they may occur with normal activities such as walking;
- Bone Scan:
- useful in patients with insufficiency fractures;
- look for vertical increase in uptake of radionuclide;
- w/ bilateral fractures, an H-shaped distribution ("Honda sign");
- pts who have these patterns should have follow-up CT scans through sacrum in order to confirm the diagnosis;
- Management:
- complete healing may take upto 9 months;
- patients require protected wt bearing in order to avoid late displacement and possible malunion;
- patient also need to be protected from sacral decubiti
Occult sacral fractures in osteopenic patients.
Transverse fractures of the sacrum. A report of six cases.
Osteoporotic sacral fractures: a clinical study.
Sacral insufficiency fractures: an often unsuspected cause of low back pain.
Insufficiency fractures of the sacrum.
Magnetic resonance appearance of sacral insufficiency fractures.
Spontaneous osteoporotic fracture of the sacrum: an unrecognized syndrome of the elderly.
Unsuspected sacral fractures: detection by radionuclide bone scanning.
Detection of osteoporotic sacral fractures with radionuclides.